Training Guidelines for the Performance of Musculoskeletal Ultrasound ExaminationsApproved November 14, 2009
Qualifications and Responsibilities of the Personnel
A. Physician
Physicians who perform and/or interpret diagnostic musculoskeletal (MSK) ultrasound examinations should be licensed medical practitioners who have a thorough understanding of the indications and guidelines for MSK ultrasound examinations as well as a familiarity with the basic physical principles and limitations of the technology of ultrasound imaging. They should be familiar with alternative and complementary imaging and diagnostic procedures and should be capable of correlating the results of these other procedures with the ultrasound findings. They should have an understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and safety. Physicians responsible for diagnostic MSK ultrasound examinations should be able to demonstrate familiarity with the anatomic, physiologic, and pathophysiologic characteristics of the anatomic areas that are being examined. These physicians should provide evidence of the training and competence needed to perform and/or interpret diagnostic MSK ultrasound examinations successfully. The training should include methods of documentation and reporting of ultrasound studies.
Physicians performing and/or interpreting diagnostic examinations should meet at least 1 of the following criteria:
1. Certification in Radiology or Diagnostic Radiology by the American Board of Radiology, the American Osteopathic Board of Radiology, the Royal College of Physicians and Surgeons of Canada, or Le Collège des Médecins du Québec, and the supervision and/or performance, interpretation, and reporting of 150 MSK ultrasound examinations within the last 36 months. Unless within 2 years of completion of a residency and/or fellowship, the radiologist will also need to have completed 40 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training.
or
2. Completion of an Accreditation Council for Graduate Medical Education (ACGME)- or American Osteopathic Association (AOA)-accredited diagnostic radiology residency program and the performance, interpretation, and reporting of 150 MSK ultrasound examinations in the past 36 months. Unless within 2 years of completion of a residency, the radiologist will also need to have completed 40 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training.
or
3. Completion of a residency or fellowship program supervised by a physician qualified to perform MSK ultrasound examinations that provides structured MSK ultrasound training, including the performance, interpretation, and reporting of 150 MSK ultrasound examinations. Unless within 2 years of completion of a residency and/or fellowship, the physician will also need to have completed 40 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound, including at least one MSK ultrasound course that includes hands-on training.
or
4. Completion of an ACGME- or AOA-accredited residency in a specialty practice plus 100 hours of AMA PRA Category 1 CreditsTM in MSK medicine, surgery, and/or imaging, of which at least 40 hours need to be specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training, and supervision and/or performance, interpretation, and reporting of 150 MSK ultrasound examinations within the last 36 months. Physicians will not need to complete the 60 hours of non-MSK ultrasound-specific CME if they are within 2 years of residency and/or fellowship training in a specialty that focuses on MSK medicine and/or surgery.
or
5. Completion of a Council on Podiatric Medical Education-accredited residency plus 100 hours of AMA PRA Category 1 CreditsTM in podiatric medicine, surgery, and/or imaging, of which at least 40 hours need to be specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training, and supervision and/or performance, interpretation, and reporting of 150 MSK ultrasound examinations within the last 36 months. Podiatrists will not need to complete the 60 hours of non-MSK ultrasound-specific CME if they are within 2 years of residency and/or fellowship training.
Maintenance of Competence
All physicians performing MSK ultrasound examinations should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 50 diagnostic MSK ultrasound examinations per year is recommended to maintain the physician’s skills.
Continuing Medical Education
The physician should complete 30 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound every 3 years.
B. Diagnostic Medical Sonographer
When a sonographer performs MSK ultrasound examinations, that person should be qualified by appropriate training to perform diagnostic ultrasound examinations. This qualification can be demonstrated by certification of same by a nationally recognized certifying body.
Qualifications and Responsibilities of the Personnel
A. Physician
Physicians who perform and/or interpret diagnostic musculoskeletal (MSK) ultrasound examinations should be licensed medical practitioners who have a thorough understanding of the indications and guidelines for MSK ultrasound examinations as well as a familiarity with the basic physical principles and limitations of the technology of ultrasound imaging. They should be familiar with alternative and complementary imaging and diagnostic procedures and should be capable of correlating the results of these other procedures with the ultrasound findings. They should have an understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and safety. Physicians responsible for diagnostic MSK ultrasound examinations should be able to demonstrate familiarity with the anatomic, physiologic, and pathophysiologic characteristics of the anatomic areas that are being examined. These physicians should provide evidence of the training and competence needed to perform and/or interpret diagnostic MSK ultrasound examinations successfully. The training should include methods of documentation and reporting of ultrasound studies.
Physicians performing and/or interpreting diagnostic examinations should meet at least 1 of the following criteria:
1. Certification in Radiology or Diagnostic Radiology by the American Board of Radiology, the American Osteopathic Board of Radiology, the Royal College of Physicians and Surgeons of Canada, or Le Collège des Médecins du Québec, and the supervision and/or performance, interpretation, and reporting of 150 MSK ultrasound examinations within the last 36 months. Unless within 2 years of completion of a residency and/or fellowship, the radiologist will also need to have completed 40 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training.
or
2. Completion of an Accreditation Council for Graduate Medical Education (ACGME)- or American Osteopathic Association (AOA)-accredited diagnostic radiology residency program and the performance, interpretation, and reporting of 150 MSK ultrasound examinations in the past 36 months. Unless within 2 years of completion of a residency, the radiologist will also need to have completed 40 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training.
or
3. Completion of a residency or fellowship program supervised by a physician qualified to perform MSK ultrasound examinations that provides structured MSK ultrasound training, including the performance, interpretation, and reporting of 150 MSK ultrasound examinations. Unless within 2 years of completion of a residency and/or fellowship, the physician will also need to have completed 40 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound, including at least one MSK ultrasound course that includes hands-on training.
or
4. Completion of an ACGME- or AOA-accredited residency in a specialty practice plus 100 hours of AMA PRA Category 1 CreditsTM in MSK medicine, surgery, and/or imaging, of which at least 40 hours need to be specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training, and supervision and/or performance, interpretation, and reporting of 150 MSK ultrasound examinations within the last 36 months. Physicians will not need to complete the 60 hours of non-MSK ultrasound-specific CME if they are within 2 years of residency and/or fellowship training in a specialty that focuses on MSK medicine and/or surgery.
or
5. Completion of a Council on Podiatric Medical Education-accredited residency plus 100 hours of AMA PRA Category 1 CreditsTM in podiatric medicine, surgery, and/or imaging, of which at least 40 hours need to be specific to MSK ultrasound, including at least 1 MSK ultrasound course that includes hands-on training, and supervision and/or performance, interpretation, and reporting of 150 MSK ultrasound examinations within the last 36 months. Podiatrists will not need to complete the 60 hours of non-MSK ultrasound-specific CME if they are within 2 years of residency and/or fellowship training.
Maintenance of Competence
All physicians performing MSK ultrasound examinations should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 50 diagnostic MSK ultrasound examinations per year is recommended to maintain the physician’s skills.
Continuing Medical Education
The physician should complete 30 hours of AMA PRA Category 1 CreditsTM specific to MSK ultrasound every 3 years.
B. Diagnostic Medical Sonographer
When a sonographer performs MSK ultrasound examinations, that person should be qualified by appropriate training to perform diagnostic ultrasound examinations. This qualification can be demonstrated by certification of same by a nationally recognized certifying body.